胆道支架在治疗胆道恶性梗阻中的应用及进展
Application and Progress of the Stents Used in the Therapy of Malignant Biliary Obstruction

作者: 陈国煜 , 李 立 , 张升宁 , 陈奕明 , 高 杨 , 张春平 :昆明市第一人民医院暨昆明医科大学附属甘美医院,云南 昆明;

关键词: 支架胆道恶性梗阻姑息治疗Stent Malignant Biliary Obstruction Paliative Therapy

摘要:
对于无法行外科根治手术的胆道恶性梗阻病人,使用胆道支架进行姑息治疗已成为首选。支架植入后能有效缓解患者临床症状,最大限度延长患者生存时间,提高患者生存质量。本文概述了目前胆道支架的分类及选择、植入方式及相关联合治疗等方面的最新研究及进展。

Abstract: Using biliary stents for palliative care has become the first choice for the patients with malignant biliary obstruction‎ who cannot undergo surgical resection. After stent implantation, it can effec-tively alleviate the clinical symptoms, maximize prolong survival time and improve the quality of life. This article summarizes the latest research and progress on the stent’s classification and se-lection, insertion methods and relevant combination treatments.

文章引用: 陈国煜 , 李 立 , 张升宁 , 陈奕明 , 高 杨 , 张春平 (2016) 胆道支架在治疗胆道恶性梗阻中的应用及进展。 临床医学进展, 6, 55-60. doi: 10.12677/ACM.2016.61011

参考文献

[1] Jaganmohan, S. and Lee, J.H. (2012) Self-Expandable Metal Stents in Malignant Biliary Obstruction. Expert Review of Gastroenterology & Hepatology, 6, 105-114.

[2] 梁凯伦, 孙大勇. 覆膜与非覆膜胆道金属支架治疗恶性胆道梗阻的临床观察[J]. 现代消化及介入诊疗, 2015, 20(5): 485-488.

[3] Park, H., Kim, M.H., Choi, J.S., et al. (2006) Covered versus Uncovered-Wallstent for Malignant Extrahepatic Biliary Obstruction: Acohort Copparative Analysis. Clinical Gastroenterology and Hepatology, 4, 790.

[4] Isayama, H., Komatsu, Y., Tsujino, T., Sasahira, N., Hirano, K., Toda, N., Nakai, Y., Yamamoto, N., Tada, M., Yoshida, H., Shiratori, Y., Kawabe, T. and Omata, M. (2003) A Prospective Randomised Study of “Covered” versus “Uncovered” Diamond Stents for the Management of Distal Malignant Biliary Obstruction. Gut, 53, 729-734.
http://dx.doi.org/10.1136/gut.2003.018945

[5] Li, F., Wang, F., Yang, X., Ji, D., Li, J., Wang, N., Liu, Y., Li, C., Zhang, T. and Li, K. (2012) Covered Stents versus Uncovered Stents for the Palliation of Malignant Extrahepatic Biliary Obstruction Caused by Direct Tumor Invasion: A Cohort Comparative Study. Medical Oncology, 29, 2762-2770.
http://dx.doi.org/10.1007/s12032-012-0187-y

[6] Saleem, A., Leggett, C.L., Murad, M.H., Baron, T.H. (2011) Meta-Analysis of Randomized Trials Comparing the Patency of Covered and Uncovered Self-Expandable Metal Stents for Palliation of Distal Malignant Bile Duct Obstruction. Gastrointestinal Endoscopy, 74, 321-327, e1-e3.

[7] Moses, P.L., Alnaamani, K.M., Barkun, A.N., Gordon, S.R., Mitty, R.D., Branch, M.S., Kowalski, T.E., Martel, M. and Adam, V. (2013) Randomized Trial in Malignant Biliary Obstruction: Plastic vs Partially Covered Metal Stents. World Journal of Gastroenterology, 19, 8638-8646.
http://dx.doi.org/10.3748/wjg.v19.i46.8638

[8] 王田田, 潘亚敏, 高道键, 吴军, 杨小明, 叶馨, 胡冰. 内镜下同期放置双侧金属支架或双侧塑料支架治疗肝门部恶性胆道梗阻[J]. 第二军医大学学报, 2013, 34(3): 252-256.

[9] 戴放, 黄信华, 陈勇, 李彦豪, 周杰, 唐玉新. 金属与塑料支架姑息性治疗恶性胆道梗阻疗效对比研究[J]. 放射学实践, 2003, 18(10): 731-734.

[10] 谢子英, 赵亚刚. 胆管恶性梗阻的内镜治疗[J]. 现代消化及介入诊疗, 2013, 18(1): 14-17.

[11] Raju, R.P., Jaganmohan, S.R., Ross, W.A., et al. (2011) Optimum Palliation of Inoperable Hilar Cholangiocarcinoma: Comparative Assessment of the Efficacy of Plastic and Self-Expanding Metal Stents. Digestive Diseases and Sciences, 56, 1557-1564.
http://dx.doi.org/10.1007/s10620-010-1550-5

[12] Kanno, Y., Ito, K., Fujita, N., et al. (2011) Single-Session Endoscopic Bilateral Y Configured Placement of Metal Stents for Hilar Malignant Biliary Obstruction. Digestive En-doscopy, 23, 91-96.

[13] Sangchan, A., Kongkasame, W., Pugkhem, A., et al. (2012) Efficacy of Metal and Plastic Stents in Unresectable Hilar Cholangiocarcinoma: A Randomized Controlled Trial. Gastrointestinal Endoscopy, 76, 93-99.

[14] Mukai, T., Yasuda, I., Nakashima, M., et al. (2013) Metallic Stents Are More Efficacious than Plastic Stents in Unresectable Malignant Hilar Biliary Strictures: A Randomized Controlled Trial. Journal of Hepato-Biliary-Pancreatic Sci- ences, 20, 214-222.
http://dx.doi.org/10.1007/s00534-012-0508-8

[15] Hong, W.D., Chen, X.W., Wu, W.Z., et al. (2013) Metal versus Plasticstents for Malignant Biliary Obstruction: An Update Meta-Analysis. Clinics and Research in Hepatology and Gastroenterology, 37, 496-500.
http://dx.doi.org/10.1016/j.clinre.2012.12.002

[16] Yasuda, I., Mukai, T. and Moriwaki, H. (2013) Unilateral versus Bilateral Endoscopic Biliary Stenting for Malignant Hilar Biliary Strictures. Digestive Endoscopy, 25, 81-85.
http://dx.doi.org/10.1111/den.12060

[17] 吴洁, 王翔. 经ERCP或PTCD胆管支架置入治疗恶性梗阻性黄疸32例体会[J]. 中国临床研究, 2013, 26(11): 1164-1165.

[18] 崔建华. 胆道金属支架在治疗胆道恶性梗阻疾病中的临床应用[J]. 中外医疗, 2015, 33: 28-29.

[19] 董家鸿, 曾永毅. 阻塞性黄疸减黄研究热点与难点[J]. 中国实用外科杂志, 2007, 10(27): 768.

[20] Jemal, A., Siegel, R., Ward, E., et al. (2009) Cancer Statistics. CA: A Cancer Journal for Clinicians, 59, 225-249.

[21] 闫勇, 戴睿武, 汪涛, 叶明辉, 张生, 江宗兴. 经PTC或ERC两种途径放置胆道支架治疗恶性胆管梗阻对比分析[J]. 中国普外基础与临床杂志, 2011, 18(11): 1184-1187.

[22] 勾承月, 秦鸣放, 王庆, 王震宇, 丁国乾. 胆道支架介入治疗恶性胆道梗阻136例临床分析[J]. 中国微创外科杂志, 2010, 10(5): 412-414.

[23] Walter, T., Ho, C.S., Horgan, A.M., et al. (2013) Endoscopic or Percutaneous Biliary Drainage for Klatskin Tumors? Journal of Vascular and Interventional Radiology, 24, 113-121.

[24] Elwir, S., Sharzehi, K., Veith, J., Moyer, M.T., Dye, C., McGarrity, T. and Mathew, A. (2013) Biliary Stenting in Patients with Malignant Biliary Obstruction: Comparison of Double Layer, Plastic and Metal Stents. Digestive Diseases and Sciences, 58, 2088-2092.
http://dx.doi.org/10.1007/s10620-013-2607-z

[25] Dumonceau, J.M., Tringali, A., Blero, D., et al. (2012) Biliary Stenting: Indications, Choice of Stents and Results: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy, 44, 277-298.

[26] Kim, B.S. and Mooney, D.J. (1998) Development of Biocompatible Synthetic Extracelluar Matrices for Tissue Engineering. Trends in Biotechnology, 16, 224.

[27] 姚红响, 陈根生, 叶冠雄, 徐胜前, 等. 胆道支架联合125I粒子条治疗恶性梗阻性黄疸[J]. 介入放射学杂志, 2014, 23(10): 893-895.

[28] 王良辉, 蒋小松, 刘恒全, 黄楠. 胆道内支架材料的研究进展[J]. 材料导报A综述篇, 2013, 27(3): 96-98.

[29] Kahaleh, M., Mishra, R., Shami, V.M., et al. (2008) Unresectable Cholangio-Carcinoma: Comparison of Survival in Biliary Stenting Alone versus Stenting with Photodynamic Therapy. Clinical Gastroenterology and Hepatology, 6, 290-297.

[30] Norbert, B., Andrea, S., Ulrich, G., et al. (1996) Hman Tissue Responses Tometal Stents Implanted in Vivo for the Palliation Of Malignant Stenoses. Gastrointestinal Endoscopy, 43, 596.

[31] 顼倩茹, 李虎城, 梁峰, 吴田田. 腔内射频消融联合胆道支架植入术和单纯胆道支架植入术治疗恶性梗阻性黄疸的临床效果分析[J]. 军事医学, 2015, 39(10): 777-780.

[32] 曹驰, 程隆, 李国均, 崔宁, 吴海江. 胆道支架植入联合高强度超声聚焦刀治疗恶性梗阻性黄疸[J]. 介入放射学杂志, 2011, 20(10): 792-794.

[33] 林少彬, 谢蓉芝, 胡碧香, 马兴灿, 方建林. 胆道支架置入联合碘油化疗药治疗胰头癌合并阻塞性黄疸的临床应用[J]. 医学影像学杂志, 2015, 25(3): 485-488.

[34] Severini, A., Mantero, S., Tanzi, M.C., et al. (1999) In Vivo Study of Polyurethane-Coated Gianturco-Rosch Biliary Z- Stens. Cardiovascular and Interventional Radiology, 22, 510.

[35] 疏云, 王洪云, 陶黎明, 吴燕玲, 邹彩亮, 胡贤春, 乐薇, 钟梅. 胆道支架置入联合三维适形放疗治疗恶性胆道梗阻的临床观察[J]. 实用癌症杂志, 2014, 29(12): 1708-1710.

[36] Li, T.F., Chen, C., Han, X.W., Zhen, L., Jiao, D.C. and Ma, J. (2014) Clinical Efficacy of Metallic Biliary Stents Combined with Different Anti-Cancer Treatments in the Management of Bile Duct Cancer. Hepato-Gastroenterology, 61, 22-26.

[37] Beydoun, N., Bucci, J. and Malouf, D. (2014) Iodine-125 Prostate Seed Brachytherapy in Renal Transplant Recipients: An Analysis of Oncological Outcomes and Toxicity Profile. Journal of Contemporary Brachytherapy, 6, 15-20.

[38] Zhang, F., Wu, K., Gao, F., et al. (2013) Refractory Nasopharyngeal Carcinoma: Positron Emission Tomography Combined with Computed Tomographyguided 125I Seed Implantation Therapy after Repeated Traditional Radiochemotherapy. Otolaryngology—Head and Neck Surgery, 149, 417-423.

[39] Peng, S., Yang, Q.X., Zhang, T., et al. (2014) Lobaplatin-TACE Combined with Radioactive 125I Seed Implantation for Treatment of Primary Hepatocellular Carcinoma. Asian Pacific Journal of Cancer Prevention, 15, 5155-5160.

[40] 任庆, 熊锐华, 田秀荣, 等. 125I粒子植入联合化疗治疗结直肠癌术后肝转移的临床研究[J]. 肿瘤防治研究, 2014, 41(6): 653-656.

[41] 赵苏鸣, 赵辉, 顾潍炜, 杨晓虎, 贾鹏飞. 单纯胆道支架与支架联合125I粒子条植入治疗恶性梗阻性黄疸[J]. 上海交通大学学报, 医学版, 2015, 35(11): 1661-1665.

[42] Saito, H., Sakurai, Y., Takamura, A., et al. (1994) Biliary Endoprosthesis Using Gore-Tex Covered Expandable Metallic Stents: Preliminary Clinical Evaluation. Nihon Igaku Hoshasen Gakkai Zasshi, 54, 180-182.

[43] Chen, M.H., Liang, P.C., Chang, K.C., Huang, J.Y., Chang, Y.T., Chang, F.Y., Wong, J.M. and Lin, F.H. (2014) Prototype of Biliary Drug-Eluting Stent With Photodynamic and Chemotherapy Using Electrospinning. Biomedical Engineering, 13, 118.

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